title: A meta-analysis of treating acute traumatic brain injury with calcium channel blockers.
abstract: The purpose of this systematic review was to evaluate and meta-analyse the current evidence for the use of calcium channel blockers (CCBs) in the treatment of acute traumatic brain injury (TBI) and traumatic subarachnoid haemorrhage (tSAH). A systematic search of clinical trials.gov, Cochrane library databases, EMBASE, MEDLINE, Web of science search and WHO trial registry, plus hand-searching of grey literature, was undertaken in March 2013. Two reviewers independently extracted the data using a pre-defined data extraction form. RevMan 5 software was used to synthesise data and calculate the risk ratio (RR) based on event rates as well as the 95% confidence interval (CI). Finally, nine RCTs with a total of 2182 patients were included. Meta-analysis showed that there was no difference between CCBs and control groups for rates of mortality (n=1337, 5 RCTs, RR 0.93 CI 0.77-1.12). In a subgroup tSAH analysis, the difference was not significant (n=389, 2 RCTs, RR 0.73 CI 0.53-1.02). There were slightly fewer unfavourable outcomes in the treatment group, but the difference was not statistically significant (n=2101, 8 RCTs, RR 0.90 CI 0.76-1.08). In the subgroup tSAH analysis, again, the difference did not reach statistical significance (n=1074, 5 RCTs, RR 0.95 CI 0.73-1.24). It seems that larger, well-designed RCTs are necessary in order to ascertain any clinical benefit CCBs may or may not have for the treatment of acute TBI.
authors.affiliation: Department of Neurosurgery, Affiliated Hospital of Xi'an Medical University, No. 48, Fenghao West Road, Xi'an 710077, Shaanxi, China. Electronic address: xgz917@126.com.
authors.forename: Gang-Zhu
authors.initials: GZ
authors.lastname: Xu
authors.forename: Mao-De
authors.initials: MD
authors.lastname: Wang
authors.forename: Kai-Ge
authors.initials: KG
authors.lastname: Liu
authors.forename: Yin-An
authors.initials: YA
authors.lastname: Bai
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.forename: Wen
authors.initials: W
authors.lastname: Li
mesh_terms: D001930:Brain Injuries / Q000188:drug therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D016208:Databases, Factual / Q000706:statistics & numerical data; D006801:Humans
chemical_list: D002121:Calcium Channel Blockers
keywords: Acute traumatic brain injury; Calcium channel blockers; Meta-analysis; Traumatic subarachnoid haemorrhage